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Remote Claims Processing Jobs in North Carolina (NOW HIRING)

KARNA LLC

$22 - $25/hr

Minimum of 5 years' experience in medical claims processing, including professional and facility ... PM18 #remote Salary Description $22-25/hour

Magicforce

Facets Analyst

Raleigh, NC · Remote

$60 - $65/hr

Job Title: Facets Analyst Location: 100% Remote Duration: 12+ Months Mandatory Skills: Facets with claims knowledge is must Facets , US healthcare payer domain, claims processing, analytical skills ...

Corvel

Claims Specialist

Charlotte, NC · Remote

$52K - $85K/yr

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives Workers' Compensation ... process taking into consideration experience, qualifications, and overall fit for the role. The ...

Corvel

Claims Specialist

Charlotte, NC · Remote

$52K - $85K/yr

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives Workers' Compensation ... process taking into consideration experience, qualifications, and overall fit for the role. The ...

Allstate

Claims Team Leader

Concord, NC · On-site +1

Skills Claims Processing, Conflict Management, Employee Supervision, Negotiation Compensation Compensation offered for this role is 80,000.00 - 136,625.00 annually and is based on experience and ...

Summit

Claims Specialist

Concord, NC · Remote

$69K - $92K/yr

Georgia, Illinois, Indiana, Kentucky, North Carolina, South Carolina, Tennessee. #LI-Remote Job ... process. Learn more at *Excludes seasonal employees and interns.

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Remote Claims Processing information

What is remote claims processing?

Remote claims processing is the evaluation and handling of insurance claims by professionals who work from locations outside of a traditional office, often from home. These processors review claim submissions, verify information, assess coverage, and authorize payments or request additional information. Remote claims processors use secure online systems and communication tools to collaborate with colleagues and clients. This role requires strong attention to detail, confidentiality, and proficiency with digital platforms. Many insurance companies now offer remote claims processing positions to increase flexibility and efficiency.

What are the key skills and qualifications needed to thrive as a remote claims processor?

To thrive as a Remote Claims Processor, you need a strong understanding of insurance policies, attention to detail, and relevant experience or education in insurance or finance. Familiarity with claims management software, electronic document systems, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, time management, and problem-solving abilities help you stand out, especially when working independently. These skills ensure accurate, timely claims resolutions and effective collaboration with clients and colleagues in a remote environment.

What are some common challenges faced in remote claims processing roles, and how can they be effectively managed?

Remote claims processing professionals often encounter challenges such as managing high volumes of claims, maintaining clear communication with team members, and ensuring data security while working from home. Effective time management and strong organizational skills are key to handling large workloads efficiently. Regular check-ins with supervisors and using secure, company-approved communication tools can help maintain collaboration and protect sensitive information. Many organizations also provide training and support to help remote processors stay up-to-date with changing regulations and best practices.

What is the difference between Remote Claims Processing vs Remote Claims Adjuster?

AspectRemote Claims ProcessingRemote Claims Adjuster
CredentialsTypically requires insurance or claims processing certificationsRequires insurance licenses and adjuster certifications
Work EnvironmentHome-based, administrative settingHome-based or field, investigative and evaluative tasks
Industry UsageInsurance companies, third-party administratorsInsurance companies, public adjusting firms
Job FocusProcessing claims, data entry, customer serviceInvestigating claims, assessing damages, settlement negotiations

Remote Claims Processing and Remote Claims Adjuster roles share similarities in industry and work environment but differ in job focus and required credentials. Claims processors handle administrative tasks and data entry, while claims adjusters evaluate damages and negotiate settlements. Both roles are essential in the insurance industry and often require specialized certifications.

What are popular job titles related to Remote Claims Processing jobs in North Carolina?

For Remote Claims Processing jobs in North Carolina, the most frequently searched job titles are:

What job categories do people searching Remote Claims Processing jobs in North Carolina look for?

The top searched job categories for Remote Claims Processing jobs in North Carolina are:

What cities in North Carolina are hiring for Remote Claims Processing jobs?

Cities in North Carolina with the most Remote Claims Processing job openings:

Remote Claims Processing jobs near you
Infographic showing various Remote Claims Processing job openings in North Carolina as of August 2026, with employment types broken down into 90% Full Time, 5% Part Time, 2% Temporary, and 3% Contract. Highlights an 100% Remote job distribution.

Experienced Healthcare Claims Processor

KARNA LLC

On-site, Remote

$22 - $25/hr

Full-time

Re-posted 5 days ago

Job description

Job Type
Full-time
Description
Join the new Bakinaw-Karna Joint Venture Team as a Temporary, Full-Time Medical Claims Processor. Become an integral part of a team dedicated to servicing the World Trade Center Health Program. In this role, you will leverage your meticulous attention to detail and commitment to accuracy in processing complex medical claims. If you're eager to make a positive impact in our community through your administrative skills, we encourage you to apply!
The Saginaw Chippewa Indian Tribe of Michigan, in accordance with the spirit of PL. 93-638, adopted January 4, 1975, will provide preference to Native Americans meeting minimum position qualifications who have equal qualifications for the position(s) to those of other applicants.
*Minimum of 5 years' experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Candidates must be located in one of the following states: FL, GA MD, MI, TX
Job Responsibilities:
  • Claims Review and Processing: Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance.
  • Critical Analysis: Analyze claims and adjudicate them according to program guidelines, employing critical thinking to navigate complex scenarios.
  • Timely Processing: Ensure claims are processed promptly to meet client standards and regulatory requirements, employing effective problem-solving skills to address any barriers.
  • Issue Resolution: Proactively resolve claim discrepancies and issues by collaborating with other departments, utilizing analytical skills to identify root causes and implement solutions.
  • Confidentiality Maintenance: Uphold the confidentiality of patient records and company information as per HIPAA regulations.
  • Detailed Record Keeping: Maintain thorough records of claims processed, denied, or requiring further investigation, ensuring transparency and traceability.
  • Trend Monitoring: Analyze and report on trends in claim issues or irregularities to management, contributing to process improvement initiatives; Assists Team Leads with reporting.
  • Audit Participation: Engage in audits and compliance reviews to ensure adherence to internal and external regulations, using critical thinking to evaluate processes.
  • Mentoring: Mentors and trains new claims processors as needed.

Requirements
  • High school diploma or equivalent.
  • Minimum of 5 years' experience in processing medical professional and facility claims as well as complex and high-dollar claims.
  • Familiarity with ICD-10, CPT, and HCPCS coding systems.
  • Must have experience working with modifiers and bill types.
  • Understanding of medical terminology, healthcare services, and insurance procedures (worker's compensation experience is a plus).
  • Strong attention to detail and accuracy.
  • Ability to interpret and apply insurance program policies and government regulations effectively.
  • Excellent written and verbal communication skills.
  • Proficient in Microsoft Office Suite (Word, Excel, Outlook).
  • Capacity to work independently as well as collaboratively within a team.
  • Commitment to ongoing education and training in industry standards and technology advancements.
  • Experience with claim denial resolution and the appeals process.
  • Ability to efficiently manage a high volume of claims.
  • Customer service-oriented with strong problem-solving capabilities.
  • Must be flexible and have the ability to adjust to the needs of the client and changes in the program.

PM18
#remote
Salary Description
$22-25/hour

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